The University of Winnipeg, Faculty of Graduate Studies

MFTDIRECTED STUDY APPLICATION FORM

MEMORANDUM OF UNDERSTANDING

BETWEEN THE MASTER OF MARRIAGE AND FAMILY THERAPY PROGRAM AND MENTOR

Steps are: (1) read the Guidelines on the back, (2) student and mentor develop a course outline indicating how the guidelines for the directed study will be fulfilled,(3) fill in this form, (4) submit this form with the course outlineto the Program Director for signature, (5) then make at least two copies of this form, one each forAlysLynne Westand Program Director, and (6) submit registration form (available from the Graduate Studies – Student Services Office) and this form with applicable fees to Student Central: Attn: Eric Benson.

NOTE:DIRECTED STUDY REGISTRATIONS SUBMITTED AFTER (5) FIVE WORKING DAYS OF COURSE COMMENCEMENT ARE SUBJECT TO A $20.00 LATE REGISTRATION FEE PER COURSE – contact the Graduate Studies – Student Services Office directly for more information.

TO BE FILLED OUT BY STUDENT (please print):

Name: ______Student #______Email: ______

Address: ______City: ______Prov. _____ Postal Code ______

Home Phone: ______Work Phone: ______Cell Phone: ______

TO BE FILLED OUT BY MENTOR (please print):

Name: ______Address: ______

City: ______Prov: ______Postal Code______Email: ______

Home Phone: ______Work Phone: ______Social Insurance Number: ______

I AGREE TO BE A MENTOR FOR (please print):

Name of Student: ______Course Number: ______

Full Name of Course: ______

Credit Hours: ______Start Date (D/M/Y): ______End Date (D/M/Y): ______

The mentor will follow the MFT Graduate Studies guidelines (see over) for Directed Study, submit a grade through WebAdvisor within one week of the ending date and notify the Program Director that it has been submitted.Upon receipt of the grade, the MMFT will remit to the mentor 85% of the tuition fee.

Signature of Mentor: ______Date: ______

Signature of Program Director (or designate),

Marriage & Family Therapy Program: ______Date: ______

See Over

Revised 5 March 2012

The Faculty of Graduate Studies

MASTER OF MARRIAGE AND FAMILY THERAPY PROGRAM

Upon completion of all forms (DS form, registration form,

applicable payment, & all required signatures), submit to:

Student Central

Attention: Eric Benson

The University of Winnipeg

Graduate Studies – Student Services

515 Portage Avenue

Winnipeg, MB R3B 2E9

Phone:(204) 786-9466

Fax: (204) 786-8656

Email:

Guidelines for Directed Study

For a three hour credit course:

  1. Normally at least eight hours of contact time with the Mentor.
  1. Approximately 2000 pages of reading (depending on the nature of the course) taken from a bibliography developed and proposed by the student in conjunction with and approved by the Mentor.
  1. An annotated bibliography of 1500 words.
  1. A 1500 word integrated reading report.
  1. A paper of approximately 5000 words.